Differential Diagnosis for Skin Conditions NURS 6512N

Assignment 1: Lab Assignment: Differential

Diagnosis for Skin Conditions

Photo Credit: Getty Images/iStockphoto
Properly identifying the cause and type of a patient’s skin condition involves a process
of elimination known as differential diagnosis. Using this process, a health professional
can take a given set of physical abnormalities, vital signs, health assessment findings,
and patient descriptions of symptoms, and incrementally narrow them down until one
diagnosis is determined as the most likely cause.

In this Lab Assignment, you will examine several visual representations of various skin
conditions, describe your observations, and use the techniques of differential diagnosis
to determine the most likely condition.Differential Diagnosis for Skin Conditions NURS 6512N
To Prepare
 Review the Skin Conditions document provided in this week’s Learning Resources, and
select one condition to closely examine for this Lab Assignment.
 Consider the abnormal physical characteristics you observe in the graphic you selected.
How would you describe the characteristics using clinical terminologies?
 Explore different conditions that could be the cause of the skin abnormalities in the
graphics you selected.
 Consider which of the conditions is most likely to be the correct diagnosis, and why.
 Search the Walden library for one evidence-based practice, peer-reviewed article based
on the skin condition you chose for this Lab Assignment.
 Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources
to guide you as you prepare your SOAP note.
 Download the SOAP Template found in this week’s Learning Resources, and use this
template to complete this Lab Assignment.
The Lab Assignment
 Choose one skin condition graphic (identify by number in your Chief Complaint) to
document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan)
note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan
text and the Comprehensive SOAP Template in this week's Learning Resources for
guidance. Remember that not all comprehensive SOAP data are included in every
patient case.
 Use clinical terminologies to explain the physical characteristics featured in the graphic.
Formulate a differential diagnosis of three to five possible conditions for the skin
graphic that you chose. Determine which is most likely to be the correct diagnosis and
explain your reasoning using at least three different references, one reference from
current evidence-based literature from your search and two different references from
this week’s Learning Resources.Differential Diagnosis for Skin Conditions NURS 6512N
By Day 7 of Week 4
Submit your Lab Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
 Please save your Assignment using the naming convention “WK4Assgn1+last
name+first initial.(extension)” as the name.
 Click the Week 4 Assignment 1 Rubric to review the Grading Criteria for the
Assignment.
 Click the Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading
criteria from this area.
 Next, from the Attach File area, click on the Browse My Computer button. Find the
document you saved as “WK4Assgn1+last name+first initial.(extension)” and
click Open.
 If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit
my paper(s) to the Global Reference Database.
 Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:
Week 4 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 4 Assignment 1 draft and review the originality report.
Submit Your Assignment by Day 7 of Week 4
To participate in this Assignment:
Week 4 Assignment 1

Learning Resources

Required Readings (click to expand/reduce)
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Seidel's guide to physical examination: An interprofessional
approach (9th ed.). St. Louis, MO: Elsevier Mosby.

 Chapter 9, “Skin, Hair, and Nails”
This chapter reviews the basic anatomy and physiology of skin, hair, and
nails. The chapter also describes guidelines for proper skin, hair, and nails
assessments.
Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia,
PA: F. A. Davis.
Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company.
Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.

This section explains the procedural knowledge needed prior to
performing various dermatological procedures.
Chapter 1, “Punch Biopsy”
Chapter 2, “Skin Biopsy”

Chapter 10, “Nail Removal”
Chapter 15, “Skin Lesion Removals: Keloids, Moles, Corns, Calluses”
Chapter 16, “Skin Tag (Acrochordon) Removal”
Chapter 22, “Suture Insertion”
Chapter 24, “Suture Removal”
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health
assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO:
Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., &
Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
Chapter 28, “Rashes and Skin Lesions”
This chapter explains the steps in an initial examination of someone with
dermatological problems, including the type of information that needs to
be gathered and assessed.Differential Diagnosis for Skin Conditions NURS 6512N
Note: Download and use the Student Checklist and the Key Points when
you conduct your assessment of the skin, hair, and nails in this Week’s
Lab Assignment.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Skin, hair, and nails: Student checklist. In Seidel's guide to
physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the
Copyright Clearance Center.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Skin, hair, and nails: Key points. In Seidel's guide to physical
examination: An interprofessional approach (9th ed.). St. Louis, MO:
Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the
Copyright Clearance Center.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.).
Philadelphia, PA: F. A. Davis.

 Chapter 2, "The Comprehensive History and Physical Exam" (Previously
read in Weeks 1 and 3)

VisualDx. (n.d.). Clinical decision support. Retrieved June 11, 2019, from
http://www.skinsight.com/info/for_professionals

This interactive website allows you to explore skin conditions according to
age, gender, and area of the body.

Clothier, A. (2014). Assessing and managing skin tears in older people.
Nurse Prescribing, 12(6), 278–282.

Document: Skin Conditions (Word document)

This document contains five images of different skin conditions. You will
use this information in this week’s Discussion.
Document: Comprehensive SOAP Exemplar (Word document)
Document: Comprehensive SOAP Template (Word document)
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation
as well as other support resources:
Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file].
Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkY
Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from https://support.shadowhealth.com/hc/en-us
Document: Shadow Health. (2014). Useful tips and tricks (Version 2)
(PDF)
Document: Shadow Health Nursing Documentation Tutorial (Word
document)
Document: Student Acknowledgement Form (Word document)
Note: You will sign and date this form each time you complete your DCE
Assignment in Shadow Health to acknowledge your commitment to
Walden University’s Code of Conduct.

Document: DCE (Shadow Health) Documentation Template for Health
History (Word document)
Use this template to complete your Assignment 2 for this week.

Optional Resources
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s
diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.

 Chapter 6, “The Skin and Nails”
In this chapter, the authors provide guidelines and procedures to aid in the
diagnosis of skin and nail disorders. The chapter supplies descriptions and
pictures of common skin and nail conditions.
Ethicon, Inc. (n.d.-a). Absorbable synthetic suture material. Retrieved from
https://web.archive.org/web/20170215015223/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/a
bsorbable_suture_chart.pdf
Ethicon, Inc. (2006). Dermabond topical skin adhesive application
technique. Retrieved from
https://web.archive.org/web/20150921174121/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/d
b_application_poster.pdf
Ethicon, Inc. (2001). Ethicon needle sales types. Retrieved from
https://web.archive.org/web/20150921171922/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/n
eedle_template.pdf
Ethicon, Inc. (n.d.-b). Ethicon sutures. Retrieved from
https://web.archive.org/web/20150921202525/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/s
uture_chart_ethicon.pdf
Ethicon, Inc. (2002). How to care for your wound after it's treated with
Dermabond topical skin adhesive. Retrieved from
https://web.archive.org/web/20150926002534/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/d
b_wound_care.pdf

Ethicon, Inc. (2005). Knot tying manual. Retrieved from
https://web.archive.org/web/20160915214422/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/k
not_tying_manual.pdf
Ethicon, Inc. (n.d.-c). Wound closure manual. Retrieved from
https://web.archive.org/web/20170829043048/http://academicdepartments
.musc.edu/surgery/education/resident_info/supplement/suture_manuals/et
h

Required Media (click to expand/reduce)

Module 3 Introduction

Dr. Tara Harris reviews the overall expectations for Module 3. Consider
how you will manage your time as you review your media and Learning
Resources for your Discussions, Case Study Lab Assignments, DCE

Assignments, and your Midterm exam (12m).

Accessible player
Online media for Seidel's Guide to Physical Examination
In addition to this week's media, it is highly recommended that you access and
view the online resources included with the text, Seidel's Guide to Physical
Examination. Focus on the videos and animations in Chapter 8 that relate to the
assessment of the skin, hair, and nails.
Note: To access the online resources included with the text, you need to
complete the FREE online registration that is located
at https://evolve.elsevier.com/cs/product/9780323172660?role=student .
To Register to View the Content
1. Go to https://evolve.elsevier.com/cs/product/9780323172660?role=student
2. Enter the name of the textbook, Seidel's Guide to Physical Examination (name of
text without the edition number) in the Search textbox.
3. Complete the registration process.
To View the Content for this Text
1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from
the textbook will not link directly to the desired online content. Use the
online menu to navigate to the desired content.
Suturing Tutorials
The following suturing tutorials provide instruction on the basic interrupted suture,
as well as the vertical and horizontal mattress suturing techniques
Tulane Center for Advanced Medical Simulation & Team Training. (2010,
July 8). Suturing technique [Video file]. Retrieved from